Provider Demographics
NPI:1508807744
Name:WRIGHT, KATHERINE A H (PHD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:A H
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227500 RIB MOUNTAIN DR STE 102
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-5052
Mailing Address - Country:US
Mailing Address - Phone:715-845-6949
Mailing Address - Fax:888-482-5792
Practice Address - Street 1:227500 RIB MOUNTAIN DR STE 102
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-5052
Practice Address - Country:US
Practice Address - Phone:715-845-6949
Practice Address - Fax:888-482-5792
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2391103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39140000Medicaid
000044314Medicare ID - Type Unspecified